Acid- base balance

Question 1

Conditions that cause Metabolic Acidosis

Answer 1

Overproduction of hydrogen ions
- Diabetic ketoacidosis and starvation
-Hypermetabolism (heavy exercise, seizure activity, fever, hypoxia, ischemia
- Increase ingestion of acids (ethyl alcohol, methanol, salicylate toxicity)

Poor elimination of hydrogen ions
-Kidney failure

Poor production of bicarb
-kidney failure
-pancreatitis
-liver failure
-dehydration

Over elimination of bicarb
- diarrhea

Question 2

Conditions that cause Respiratory acidosis

Answer 2

Under elimination of hydrogen ions

Respiratory depression (anesthetics, opioids, poison, electrolyte imbalance)

Poor chest expansion
(muscle weakness, airway obstruction, alveolar-capillary block, obesity, fail chest, sleep apnea, pneumothorax, hemothorax, neck edema, pulmonary edema, chest trauma, clots)

Question 3

What are the ABG’s of respiratory acidosis

Answer 3

pH = low
PaCO2 = high
Bicarb = will be normal or high for comp

Question 4

What are the ABG’s of respiratory alkalosis

Answer 4

pH = high
PaCO2 = low
Bicarb = will be normal or comp

Question 5

What are the ABG’s of metabolic acidosis

Answer 5

pH = low
PaCO2 = normal or comp
Bicarb= low

Question 6

What are the ABG’s of metabolic alkalosis

Answer 6

pH =high
Paco2 = normal or comp
Bicarb = high

Question 7

S/S of acidosis ( same in metabolic and respiratory)

Answer 7

Body systems and tissue will have decreased excitability

Cardiovascular
low BP, bradycardia, thready peripheral pulses
CNS
depressed activity (lethargy, confusion, stupor, coma)
Neuromuscular
hyporeflexia, skeletal muscle weakness, flaccid paralysis
Respiratory
Kussmaul breathing ( found in metabolic acidosis with respiration comp)
respirations vary
Integumentary
warm flushed skin, dry skin in metabolic
pale/cyanotic skin

Question 8

S/S of alkalosis

Answer 8

Body systems and tissue will have increased excitability

CNS
increased activity, anxious, irritability, tetany, seizures, Pos chevotks, trousseau signs, paresthesia’s

Neuromuscular
hyper reflex’s, muscle cramps and twitching, skeletal muscle weakness

Cardiovascular
increased heart rate, normal or low BP, increased digoxin toxicity

Respiratory
hyperventilation
decreased respiratory weakness due to skeletal muscles are weak

Question 9

Interventions for metabolic acidosis

Answer 9

Hydration
drugs or treatments to control the problem causing metabolic acidosis
Antidiarrheal

Question 10

Interventions for respiratory acidosis

Answer 10

ventilatory support for pt who cannot keep O2 above 90% or have respiratory muscle fatigue
drug therapy to improve ventilation and gas exchange
O2 therapy will promo gas exchange
preventing complications

Question 11

Interventions for alkalosis

Answer 11

to prevent further loss of hydrogen, potassium, calcium, and chloride ions

to restore fluid balance, to monitor changes, and to provide patient safety

Stop prolong NG suction, lots of infusion of certain IV fluids, drugs that promo hydrogen ion excretion

Question 12

Conditions that cause Metabolic alkalosis

Answer 12

Too much bases- antacids
Parenteral base admin- blood transfusions, NA bicarb, TPN

Decreased acid components- prolonged vomiting, NG suctioning, hypercortisolism, hyperaldosteronism, loop and thiazide diuretics

Question 13

Conditions that cause respiratory alkalosis

Answer 13

High loss of CO2
Hyperventilating
mechanical ventilation
early stage acute pulmonary problems
salicylate toxicity